MAIPF

Ballot for Bulletin No. 158

MAIPF Plan of Operation
(Current Plan)
Section 11 - Unreported Base Data

Bulletin 158 | Proposed Revision | 2005 Vote Weights | Ballot to Complete by Hand

Online Voting Deadline is December 30, 2005

Please record our company weighted vote as follows:
  APPROVE
  DISAPPROVE
 
Name:  
Title:  
Completed by:  
Member Company Name:  
Vote Weight:  
Direct Premiums Written:  
Date:   9/7/2010
Phone Number:  
E-mail Address:  
Please note any change of name, ownership or status:  
 
Submit one ballot for each company.
 
 
If you have any problems with this form,
please call 734.464.1100 x 222 or
send an e-mail message.

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